Targeting Angiotensin-converting Enzyme Inhibitor via Enalapril Reduces Postsurgical Adhesion Band Formation

Abstract

Background: Postoperative adhesions commonly occur after abdominal surgery and can lead to significant complications. There is increasing evidence that targeting the renin-angiotensin system (RAS) can reduce inflammation and fibrosis. This study investigates the therapeutic potential of enalapril, an RAS inhibitor, in a rat model of postsurgical adhesion band formation. Methods: A total of 12 male albino Wistar rats received intraperitoneal administration of enalapril (10 mg/kg). After 9 days, the anti-inflammatory and antifibrotic effects were evaluated using RTPCR and ELISA, alongside hematoxylin and eosin and Masson's trichrome staining. Result: The statistical analysis of findings showed that enalapril significantly reduced the frequency and stability of adhesion bands. It attenuated submucosal edema by suppressing pro-inflammatory cytokines, decreasing pro-inflammatory cell infiltration, and inhibiting oxidative stress at the peritoneal surgery site. Additionally, enalapril inhibited fibrotic adhesion band formation by reducing collagen deposition and suppressing the expression of profibrotic genes in peritoneal adhesion tissues. Conclusion: These findings demonstrate the therapeutic potential of enalapril in preventing postsurgical adhesion band formation by inhibiting key pathological responses of inflammation and fibrosis, supporting its use as a preventive treatment in postoperative adhesion management.